Doctor Name: | MRS. SADIE ANN JENKINS |
NPI Number: | 1073935557 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN, PW, CM |
License Number: | R 156967-6 |
Business Practice Address: | 1805 Ford Ave N Ste 200 Glencoe, MN - 553361371 |
Business Phone Number: | 3208643185 |
Business Fax Number: | 3208641484 |
Mailing Address: | 1805 Ford Ave N Ste 200, GLENCOE |
State: | MN |
Postal Code: | 553361371 |
Phone Number: | 3208643185 |
Fax Number: | 3208641484 |
NPI Enumeration Date: | 01/17/2014 |
NPI Last Update Date: | 01/17/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WC0400X |
License Number: | R 156967-6 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Case Management |
Taxonomy Definition: |